ArticleBMC nutrition2023
The effect of short-term preoperative nutritional intervention for cleft surgery eligibility.
Article in BMC nutrition, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Systematic Review of Growth in Young Children With Cleft Lip and/or Cleft Palate From 0 to 24 Months of Age.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2026Pooled it
- Anthropometric status among infants with cleft lip and palate: a cross-sectional, single-center study in Indonesia.BDJ open · 2026Article
- Food Security Impacts Health of Children With Orofacial Clefts: An 8-Year Review of the Global Burden of Disease Study.The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association · 2026Article
- Barriers and delays in access to cleft surgery among children with cleft deformities in Rwanda: a qualitative study.BMJ open · 2026Article
- Prevalence and Factors Associated With Preoperative Malnutrition Among Nonsyndromic Cleft Lip and Palate in Rwanda.Plastic and reconstructive surgery. Global open · 2026Article
- Special considerations for international weight standards for cleft surgery: presurgical optimisation in a patient with femoral-facial syndrome.BMJ case reports · 2025Article
- Preoperative nutrition intervention program increases cleft surgery eligibility in the low- and middle-income country setting.BMC nutrition · 2025Article
- Nutrition and diet in children with orofacial clefts in Africa: a scoping review.BMC oral health · 2024Article
- Growth Parameters in Children with Non-syndromic Cleft Lip and Palate versus Healthy Controls: A Cohort Study from Riyadh, Saudi Arabia.Saudi journal of medicine & medical sciencesArticle
- Lack of Immediate Diagnosis and Appropriate Intervention Leads to Malnutrition in an Infant With Cleft Palate.Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & PractitionersArticle
- Reducing delayed detection of isolated cleft palate-related deformity: a call for routine intraoral examination of newborns.Jornal de pediatriaReview
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChildren with orofacial clefts are highly susceptible to malnutrition, with severe malnutrition restricting their eligibility to receive safe surgery. Ready-to-use therapeutic foods (RUTF) are an effective treatment for malnutrition; however, the effectiveness has not been demonstrated in this patient population prior to surgery. We studied the effectiveness of short-term RUTF use in transitioning children with malnutrition, who were initially ineligible for surgery, into surgical candidates.
methodsA cohort of patients from Ghana, Honduras, Malawi, Madagascar, Nicaragua, and Venezuela enrolled in a nutrition program were followed by Operation Smile from June 2017 to January 2020. Age, weight, and length/height were tracked at each visit. Patients were included until they were sufficiently nourished (Z > = -1) with a secondary outcome of receiving surgery. The study was part of a collaborative program between Operation Smile (NGO), Birdsong Peanuts (peanut shellers and distributors), and MANA Nutrition (RUTF producer).
resultsA total of 556 patients were recruited between June 2017 and January 2020. At baseline 28.2% (n = 157) of patients were diagnosed with severe, 21.0% (n = 117) moderate, and 50.7% (n = 282) mild malnutrition. 324 (58.3%) presented for at least one return visit. Of those, 207 (63.7%) reached optimal nutrition status. By visit two, the mean z-score increased from -2.5 (moderate) to -1.7 (mild) (p < 0·001). The mean time to attain optimal nutrition was 6 weeks. There was a significant difference in the proportion of patients who improved by country(p < 0.001).
conclusionMalnutrition prevents many children with orofacial clefts in low- and middle-income countries from receiving surgical care even when provided for free. This creates an even larger disparity in access to surgery. In an average of 6 weeks with an approximate cost of $25 USD per patient, RUTF transitioned over 60% of patients into nutritionally eligible surgical candidates, making it an effective, short-term preoperative nutritional intervention. Through unique partnerships, the expansion of cost-effective, large-scale nutrition programs can play a pivotal role in ensuring those at the highest risk of living with unrepaired orofacial clefts receive timely and safe surgical care.
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